Latest news with #rash
The Star
3 days ago
- Health
- The Star
Penang remains vigilant as HFMD cases decline
ALTHOUGH the number of cases of hand, foot and mouth disease (HFMD) has declined, medical professionals are urging parents to be vigilant as the virus remains prevalent within the community. Family medicine specialist Dr Mastura Mohd Sopian said parents should look for signs such as fever, mouth ulcers or a rash before sending their children to school. Gooi: Penang saw a peak in HFMD cases in epidemiology week 19, with 1,152 cases recorded,. 'Children must make it a habit to wash hands after playtime, after using the toilet, before eating and after coughing or sneezing,' said Dr Mastura of Universiti Sains Malaysia's (USM) Advanced Medical and Dental Institute. 'Provide them with their own water bottle, utensils and towel. 'Also, remind them not to put their hands in their mouths unnecessarily,' she said. HFMD is a common infection caused by a group of enteroviruses. It typically begins with a fever and a general feeling of being unwell, followed a day or two later by flat, discoloured spots or bumps that may blister. These usually appear on the hands, feet and mouth, and occasionally on the buttocks and groin. In recent weeks, some schools have reportedly shifted certain classrooms to online lessons due to the spread of HFMD cases. Dr Mastura said schools must adhere to cleaning protocols, enforce sick-child exclusion policies and promptly notify parents if any child fell ill. 'Children should cover their mouths and nose when coughing or sneezing, and dispose of used tissues properly. Dr Mastura: Schools must adhere to cleaning protocols. 'Parents should also disinfect frequently touched surfaces such as toys, tables, doorknobs and bedding,' she added. If a child shows symptoms or feels unwell, it is best to isolate them, Dr Mastura said. 'Keep your children at home and take them to a doctor for diagnosis and advice. 'Inform the school teacher in case other children may also be infected. 'Monitor your child for complications such as high fever, drowsiness or breathing difficulties. 'Children with symptoms should remain at home until they have fully recovered. This means until the blisters have dried and there is no fever. 'Do not share cups, utensils, towels or bedding with someone who has HFMD,' she reminded. Dr Mastura also encouraged parents to teach their children to speak up if they felt unwell, especially during class. Rachel Ng, who runs a chain of after-school care centres, said two common habits among children were rubbing their eyes and wearing face masks improperly. She said these could increase the risk of infection and make it harder to contain outbreaks. 'We keep reminding the children not to do so. 'When they wear masks, sometimes the mask slips down and does not cover the nose. 'We have to tell them to wear them correctly,' she said, adding that her centres check their children's temperatures twice a day. 'If someone has a fever, we isolate them and call the parents to pick them up,' said Ng. The centres hold a weekly assembly to remind the children of the 'do's and don'ts' of good hygiene, and rewards are given to those who adopt such practices. Penang health committee chairman Daniel Gooi said that as of epidemiology week (EW) 31 this year, Penang had recorded a total of 15,824 HFMD cases. For EW31 alone, he said Penang had 265 cases, a 27.4% drop compared to EW30, which recorded 365 cases. 'We saw a peak in HFMD cases at EW19, with 1,152 cases recorded, but the numbers have since declined gradually,' he said. Gooi said the state Health Department would be informed when schools in Penang reported an outbreak of HFMD or the chickenpox. 'According to the Health Ministry's directive, an outbreak is defined as two or more cases in the same locality within the disease's incubation period. 'For schools or kindergartens, an outbreak refers to two or more cases with within a two-week interval that are epidemiologically linked,' he explained. Gooi stressed that when a suspected outbreak is reported, it is important to ensure that infected children stay away from the institution for at least 10 days after the onset of symptoms. He said the children must also be certified as free from infection by a registered medical practitioner before returning to school. 'Active case detection will be conducted among close contacts at the institution and within the affected child's family. 'All symptomatic individuals will be referred to the nearest health clinic for treatment,' he added.
CNA
05-08-2025
- Health
- CNA
Patient given immunosuppressant for rash hospitalised for serious side effects; doctor suspended
SINGAPORE: A dermatologist who saw a patient with a rash prescribed him an immunosuppressant and a corticosteroid, but failed to tell him about a possible serious side effect of the former and to monitor his condition closely. As a result, the patient developed blisters in his mouth, darkened skin and hair loss that resulted in him being hospitalised for 10 days. He had suffered a rare adverse reaction to the immunosuppressant and developed bone marrow suppression that resulted in pancytopenia, a rare condition where counts of red blood cells, white blood cells and platelets are all low. The patient, who was not named in a judgment published on Aug 1, lodged a complaint with the Singapore Medical Council (SMC), and a disciplinary tribunal ordered that Dr Khoo Boo Peng be suspended for 14 months. WHAT HAPPENED According to the judgment, Dr Khoo was practising at Naaman Skin and Laser Centre in April 2020 when he saw the patient for a rash he had on his body for about eight months. Dr Khoo diagnosed him with prurigo nodules or papules and gave him a steroid injection. About two weeks later, Dr Khoo prescribed the patient with cyclosporin and methotrexate. The patient felt well about a month later and did not show side effects from the drugs. However, as the medications were expensive to continue in the long term, they were stopped, and the patient was given an open appointment. On Jun 12, 2020, the patient relapsed and consulted Dr Khoo again. This time, he prescribed 2mg per kg per day of azathioprine, an immunodepressant, and prednisolone, a corticosteroid. About two weeks later, the patient sent Dr Khoo an email with two photos of his face, expressing concern that the area of his face below his lips was "a little swollen", with skin that was darker than normal. Dr Khoo replied that this was likely due to fluid retention caused by the prednisolone. He said it was temporary and asked the patient to continue his medications. On Jul 1, 2020, the patient sent another email to Dr Khoo, saying: "The steroid has caused blisters near my lips and mouth sores and (is) probably affecting the tongue and throat as well." "It feels painful when I eat and swallow. The darkening of skin is also quite bad," he said. He told Dr Khoo that he had brought forward his appointment to see him from Jul 9 to Jul 4 in 2020. Dr Khoo replied that he would see him then. At 3am the next day, the patient emailed Dr Khoo to ask if he could take a medication known as danzen to treat his painful mouth sores, and was given the green light. That same day, on Jul 2, 2020, the patient sent further emails about his condition. He attached a photo showing the hair he had lost that morning and said it had never happened before. "(Please) advise what to do with the steroid. It is killing me. I want to stop but (scared) of the withdrawal symptoms also," he wrote. Dr Khoo responded: "I agree with you. Stop." This was only in reference to the prednisolone, the tribunal heard. After this email correspondence, the patient consulted Dr Khoo at his clinic on an urgent basis. It was only then that Dr Khoo told him that the symptoms could be an adverse reaction to azathioprine. The patient sought treatment at the accident and emergency department of Mount Elizabeth Novena Hospital two days later and was admitted from Jul 4 to Jul 13 in 2020. He was diagnosed with bone marrow suppression, where the bone marrow's ability to produce blood cells is reduced, and resulting pancytopenia, a potentially life-threatening condition. Test results conclusively determined that the patient was a poor metaboliser of azathioprine, and this resulted in the severe complications he suffered. DOCTOR PLEADS GUILTY Dr Khoo pleaded guilty to two charges of professional misconduct under the Medical Registration Act for prescribing azathioprine to the patient without ensuring his safety, and for failing to monitor him closely and properly manage his side effects after starting him on the drug. Before prescribing azathioprine, a reasonable doctor was required to advise the patient on the option for testing to see if the patient is a normal, intermediate or poor metaboliser of the drug. If a patient chooses not to undergo the tests, a reasonable doctor should adopt a cautious approach and start the patient on the lowest dosage of 1mg per kg per day, to test the patient's susceptibility to the drug. Dr Khoo did not do this. Caution was required as there could be serious side effects if a high dose of azathioprine is prescribed to a patient who is a poor metaboliser of the drug, the tribunal heard. Dr Khoo also failed to schedule close monitoring of the patient and order full blood count tests every week or every two weeks, as well as liver function tests for the first four to six weeks, to manage the risks associated with azathioprine and detect any negative reactions to it. In mitigation, Dr Khoo said he did ask the patient to come back in two weeks to be monitored for common side effects and take a blood test if necessary. However, the tribunal noted no written record that Dr Khoo had done this and that the patient had declined. Given that the medication package insert for azathioprine stated that close blood monitoring was "mandatory", the tribunal found it "odd" that Dr Khoo did not record this in writing. In any case, Dr Khoo's claim was only related to common side effects. He did not inform the patient about the possibility of other serious side effects such as leucopenia, or low white blood cell count. The tribunal said it appeared that the patient had not been informed that close blood monitoring was mandatory, and he may not have been making a fully informed decision if he really had declined to return in two weeks. The SMC said that even if it accepted the explanation that the decision to prescribe azathioprine was due to cost concerns, this did not reduce Dr Khoo's culpability. They called an expert who said Dr Khoo's failure to carry out close monitoring had resulted in the patient's hospitalisation. While Dr Khoo's failures did not directly cause the condition, they contributed to the severity and extent of the side effects the patient suffered, said the SMC. Blood monitoring could have prevented or arrested the adverse reaction at an early stage and reduced the harm caused to the patient, said the SMC. Dr Khoo "failed to act with the necessary urgency" and promptness after learning of the patient's symptoms, and this showed "a blatant disregard" for his well-being, said the SMC. He did not call the patient in for an early review of his symptoms, did not tell him to cease the drug use and did not consider the possibility that the patient was facing an adverse reaction to azathioprine. DEFENCE ARGUMENTS Dr Khoo's lawyers argued that their client's conduct did not "in and of itself" cause the patient to suffer harm. Instead, the harm was the result of the patient being a poor metaboliser. They argued that the harm that resulted was not the patient's pancytopenia, but a "slight delay in treatment" from the time the patient first contacted Dr Khoo until Jul 2, 2020, when the patient went to the clinic and was told to seek help. The lawyers submitted that the patient was warded for 10 days and did not die, so the level of harm in this case was "slight". They also said Dr Khoo's original intention was to get the patient to return within two weeks, but the patient requested a review in four weeks' time. When the patient contacted Dr Khoo, the symptoms "were not obvious signs of an adverse drug reaction to azathioprine", so Dr Khoo was under the "mistaken impression" that prednisolone was the cause. TRIBUNAL'S FINDINGS The tribunal noted that the patient's white cell count was "extremely low" when admitted to hospital. He was placed on antibiotics and came out of neutropenia – an abnormally low concentration of a certain type of white blood cell – on Jul 12, 2020. "This was a critical period as the low white blood cell count meant there was potential for immense harm to be caused to the patient through opportunistic infections," said the tribunal, noting that the high quality of medical care at the hospital "may well have prevented him from suffering even more harm". The tribunal was prepared to accept that Dr Khoo was unaware of the guidelines that recommend testing, and that his actions were negligent rather than intentional. Nevertheless, it was clear that a reasonable practitioner in his position would have been aware of these guidelines. The guidance on offering two types of testing may have been relatively new, but the tests had been recommended for a year and four years, respectively. Given that Dr Khoo had implied that he had prescribed the drug to other patients, he ought to have kept himself up to date on the latest guidance, said the tribunal. The tribunal accepted that the case involved a single prescription and not a sustained course of conduct, and the issue was not with prescribing azathioprine per se but the failure to offer the required testing. Dr Khoo's lawyers had submitted that leucopenia is the most common adverse event for azathioprine, while pancytopenia is a rare complication, so it did not occur to Dr Khoo that the patient may be suffering from pancytopenia. The tribunal noted that azathioprine suppresses the natural immune system, and the most dangerous and potentially life-threatening yet common side effect of suppressing the natural immune system is leucopenia. Someone suffering from pancytopenia would also be suffering from leucopenia. "Therefore, even if it did not occur to (Dr Khoo) that the patient was suffering from pancytopenia because it was a rare adverse event, it could not excuse (his) failure to consider the possibility that the patient was suffering from a potentially life-threatening yet common side effect which was leucopenia," said the tribunal. The tribunal also noted that if there had been proper monitoring, the patient's condition may not have required such an extended hospital stay, or even admission at all. He had received an additional five days of azathioprine dosage from his first report before Dr Khoo asked him to stop taking the drug. Secondly, Dr Khoo ought to have told the patient to stop both medications once a side effect was reported. This is conventional medical practice, and the tribunal found it "surprising" that Dr Khoo did not do so, given that he claimed he had wanted to monitor the patient for side effects. "These medications were not essential, and stopping them temporarily pending a full evaluation would not have major repercussions to the patient's health," said the tribunal. If it were not for the patient's own initiative to go down to the clinic earlier, the harm caused may well have been far worse, the tribunal said. Other than the suspension, the tribunal also ordered that Dr Khoo be censured, pay the costs of the proceedings and give a written undertaking to the SMC that he would not engage in such conduct in future.
News18
23-07-2025
- Automotive
- News18
SUV gets stuck on beach near Surat; owner arrested for rash driving
Last Updated: Surat, Jul 23 (PTI) A man drove his high-end SUV on the Dumas beach near Surat, where the car eventually got stuck in sand, prompting the police to arrest him for rash driving, officials said on Wednesday. The police will also request the insurer of the SUV, a Mercedes-Benz car valued at more than Rs 1 crore, not to approve any claim for damages so as to send across a message to people to refrain from taking their vehicles to prohibited areas, they said. The administration has through a notification prohibited taking four-wheelers on the beach. The sports utility vehicle (SUV) was pulled out from the marshy beach on Tuesday after nearly 36 hours, an official said. In a short video which went viral on social media platforms a couple of days back, two men can be seen standing helplessly near the stranded car on the Dumas beach. After learning about the incident through the viral clip, local police tracked down the owner, identified as 50-year-old Aksar Abdulla Shah, on Tuesday and arrested him on charges of rash driving under section 281 of the Bharatiya Nyaya Sanhita, an official said. 'Shah claimed the incident took place on Sunday morning when he went to the Dumas beach with his wife in their SUV. While driving the car on the marshy beach, the vehicle eventually got stuck in the sand," Assistant Commissioner of Police Deep Vakil said. The man was later granted bail, he said. After being stuck for nearly 36 hours, the SUV was pulled out of the thick layer of sand on Tuesday, Vakil said. 'To set an example for such people who take their vehicles in prohibited areas, we will report this incident to the insurance firm to ensure that Shah does not get any money for the damages," the police officer said. PTI COR PJT PD GK view comments First Published: July 23, 2025, 15:30 IST Disclaimer: Comments reflect users' views, not News18's. Please keep discussions respectful and constructive. Abusive, defamatory, or illegal comments will be removed. News18 may disable any comment at its discretion. By posting, you agree to our Terms of Use and Privacy Policy.
Daily Mail
16-07-2025
- Health
- Daily Mail
Woman, 30, left in agony after developing rare condition which makes her feel like she's been set on fire
When Rachel Bradford first noticed a blotchy rash breaking out over her skin, she put it down to pregnancy. But within weeks the expectant mother was in excruciating pain leaving her with the complexion of 'a dead person' and practically immobile. As her due date loomed closer, Ms Bradford, 30, and her husband Jack, from Devon, pushed for answers after she suffered uncontrollable spasms and her skin began to blister, forcing her to step back from work. 'It feels like I'm burning alive, like my body is constantly on fire,' the support worker said. 'I was praying the pain would stop—I couldn't take it anymore and I felt no one was listening to me, no one was taking me seriously.' After calling NHS 111, the couple were advised to seek help at Royal Devon and Exeter Hospital, where they were told her condition was not a cause for concern. 'We were still being told it could go away after pregnancy, it was just sort of brushed off,' her husband added. Then, unable to give birth naturally due to her swollen limbs that saw her wheelchair bound, Ms Bradford was forced to give birth to her son, Michael, via emergency C-section on May 31 2024. 'I couldn't have a natural birth anyway because I couldn't open my legs', she explained. 'They were so swollen from the condition and my mobility was almost nothing at that point.' But the burning sensation did not subside after she gave birth, leaving her contemplating taking her own life just months after her son was born. It was until almost a year later, however, that the true cause of her burning symptoms came to light. In February this year, the young mother was diagnosed with erythromelalgia—a rare condition that causes burning pain, redness and hot skin, along with chronic regional pain syndrome (CRPS). 'It's thought the condition is related to her blood vessels,' Mr Bradford explained. 'So they will either completely constrict and she will look like a dead person, or it will go the other way to the point her skin will blister.' Along with the classic symptoms of the condition, which include burning pain that often starts as itching, redness and swelling the mother-of-one also suffers from spasms, brain fog, joint pain and loss of feeling in her extremities. She said: 'The condition has taken everything from me. Pregnancy, motherhood, my job my mobility, my independence—I can't even play with my son.' 'She can't escape it. From the moment she opens her eyes, it's the first thing she feels,' her husband added. 'If Michael, now one, sits on Rachel's lap for even for even just five minutes it causes her thighs to flare up. 'Rachel is an amazing mum and to see her completely limited by something outside of her control is absolutely horrendous.' A flare-up can come last anywhere from a few minutes to a few days, leaving Ms Bradford's skin looking blue. Ms Bradford is now trying new medications to help manage symptoms, but the couple say they are 'disappointed' with the standard of care offered by the hospital. Mr Bradford said when they visited Royal Devon and Exeter Hospital for his wife's pain, staff told her to 'put some socks on' and sent her away, insisting there was nothing they could do to help her. 'We've found it all so frustrating,' he said. 'It's been endless amounts of disappointment and it's not given us any hope.' The couple have now launched a GoFundMe page, which has raised over £2,000 so far, to help them fund scrambler therapy in Italy—a non-invasive treatment helping patients in chronic pain. 'If we have the money for another option, another treatment…I don't want Rachel to be hitting a point where she says we have nothing more to try,' Mr Bradford said. The hospital has since issued an apology and have encouraged Mrs Bradford to raise her concerns with their complaints team for further investigation. A spokesperson for the hospital said: 'We are dedicated to providing safe, high-quality care to our patients with compassion and we're very sorry to hear that Mrs Bradford's experience of care did not meet these standards.' Torbay and South Devon NHS Foundation Trust added in a statement: 'Last year we received correspondence on behalf of Rachel Bradford via our Patient Advice and Liaison Service. 'In our response we apologised that Rachel's experience of her care was not a positive one; we are committed to learning from feedback and improving the experience of women and their families who attend our departments for their care.' According to the NHS, it is not clear what causes erythromelalgia. Sometimes the condition can be triggered by a faulty gene or brought on by another condition. Whilst treatment can vary depending on the cause, most treatments aim to prevent flare-ups which are usually triggered by an increase in body temperature. Treatments options include medicines, creams, gels, sprays, tablets and medicines injected directly into the bloodstream. Rarely, sufferers will need surgery.
Hindustan Times
14-07-2025
- Hindustan Times
Teen pillion rider killed as dumper hits bike
Mumbai: A 19-year-old pillion rider died after being run over by a dumper in a hit-and-run case on Sion-Panvel highway in Mankhurd on Saturday morning. He and his friend, who was riding the bike, were on their way to Raigad on a trekking trip arranged by their college. As they were late to register for the trek, the seats in the bus were filled up and they had to go on their bike, the police said. Teen pillion rider killed as dumper hits bike The deceased, Hasan Amirullah Idrisi, was a third year student of Bachelor of Science at Sree Narayana Guru College of Commerce in Chembur. According to the police, the accident occurred on Saturday at 6.30 am when Idrisi's college friend, Ashraf Anwar Shaikh, 20, picked him up from his home in Baiganwadi and started towards Raigad. 'Shaikh and Idrisi were late to register for the trek. So the seats in the bus were filled up and they had to go on their bike. Shaikh was driving,' said a police officer and added that when they halted at a petrol pump in Mankhurd, they found a few of their college friends who were also on their way to Raigad on their bikes. 'Suddenly a dumper came from beside us and rammed into our bike from the left side. The dumper's tyre ran over Idrisi's head and stomach,' said Shaikh. Idrisi and Shaikh were rushed to Rajawadi hospital in Ghatkopar where Idrisi was declared dead and Shaikh sustained injuries on his knees and stomach, the officer said and added, 'Their friends followed and intercepted the dumper. The driver got down and fled from the spot leaving the dumper there.' A case has been registered against the unidentified driver under sections 106 (1) (causing death by negligence), 125 (a) (acts endangering human life or personal safety) and 281 (rash driving or riding on a public way) of the Bharatiya Nyaya Sanhita and relevant sections of the Motor Vehicle Act.
